Application Form For Claiming Unemployment Allowance
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4Form No.U.A.E.P.-1
APPLICATION FORM FOR CLAIMING UNEMPLOYMENT ALLOWANCE TO
BE SENT TO THE EMPLOYMENT EXCHANGE WHERE AN UNEMPLOYED
EDUCATED PERSON IS REGISTERED.
1.
Name of the applicant (In Block letters):
2.
Father’s Name (In respect of men and unmarried women):
3.
Husband’s Name (In respect of married women):
4.
Permanent address:
5.
Name of Employment Exchange where registration is continuing:
6.
Current Registration number allotted by the Exchange:
7.
Occupation and N.C.O. in which registered.
8.
Applicant’s educational qualifications:
Qualifications
Date from which registered
at the Exchange.
(i)
Matric or equivalent
As Matric
As Graduate
(ii)
Graduate
9.
Documents to be attached with the application form.
(i)
Three specimen signatures, dully attested by a Gazetted Officer.
(ii)
Domicile Certificate issued by a competent authority (This Certificate is needed
to be given by the residents of Punjab but living at Chandigarh).
(iii)
An affidavit duly attested by a Magistrate/ Oath Commissioner in support of his/
her claim for unemployment allowance.
(i)
A Medical Certificate from Medical Officer of Government Hospital/ Dispensary
(To be furnished duly by blind, deaf and dumb applicants registered with the
special Employment Exchange for Physically Handicapped persons, Punjab,
Chandigarh).
(ii)
A certificate of being of Punjab origin (To be furnished by blind, deaf and dumb
applicants only).
(iii)
Three passport size photographs of the applicant, “dully attested by a Gazetted
Officer”.
Signature of applicant
Place:
Date:
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